Participation in the special supplemental nutrition program for women, infants, and children and dietary intake in children: Associations with race and ethnicity

Authors: ZIMMER, MEGHAN - National Cancer Institute (NCI, NIH); Moshfegh, Alanna; VERNARELLI, JACQUELINE - Sacred Heart University; BARROSO, CRISTINA - University Of Tennessee

Submitted to: American Journal of Preventive Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/4/2021
Publication Date: 12/27/2021
Citation: Zimmer, M., Moshfegh, A.J., Vernarelli, J.A., Barroso, C.S. 2021. Participation in the special supplemental nutrition program for women, infants, and children and dietary intake in children: Associations with race and ethnicity. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2021.10.017.
DOI: https://doi.org/10.1016/j.amepre.2021.10.017

Interpretive Summary: Racial and ethnic disparities in dietary intake of children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been documented in the literature. This study evaluated dietary intake of Hispanic and black children 2-4 years of age in the National Health and Nutrition Examination Survey (NHANES) 2011-2016 to determine if differences exist by WIC participation status and income level. Comparisons were made of mean nutrient and food group intake of children participating in WIC (reference group) with nonparticipants who were income-eligible and income-ineligible (above income limits) for the WIC program. Results showed that participation in WIC was associated with better dietary intake than nonparticipation regardless of income status among Hispanic/Latino preschool aged children. Hispanic/Latino WIC participants consumed more fiber, calcium, iron, total fruit, and whole grains compared with income-eligible counterparts; and more fiber, potassium, and fewer added sugars compared with income-ineligible (higher income) counterparts. The results suggest that participation in WIC has the greatest positive impact in the Hispanic/Latino group, where the prevalence of childhood obesity is highest. Diets of black children were generally comparable by WIC participation status and income, though the proportion that vegetable and dairy subgroups contributed to total vegetable and total dairy intake varied. This study, based on nationwide data, provides evidence for policymakers and nutrition educators that the critical role of WIC in supporting sound nutrition is being achieved among low-income racial and ethnic children.

Technical Abstract: Racial and ethnic disparities in dietary intake of children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have been documented in the literature. However, it remains unknown how the diets of minority children who participate in WIC compares with children who do not participate in the program. The objective of this study was to evaluate dietary intake of Hispanic and non-Hispanic black children by WIC participation status and income level. Children 2-4 years of age in the National Health and Nutrition Examination Survey (NHANES) 2011-2016 were included in this cross-sectional study. Multivariable linear regression was used to compare mean nutrient and food group intake of children participating in WIC (reference group) with nonparticipants who were income-eligible and income-ineligible (above income limits) for the WIC program. Among Hispanic children, WIC participants reported greater consumption of fiber (13.0±0.6 g vs. 11.4±0.7 g, p<0.05), calcium (1046±42 mg vs. 876±76 mg, p<0.01), iron (11.7±0.4 mg vs. 10.4±0.7 mg, p<0.05), total fruit (1.7±0.1 cup eq. vs. 1.0±0.2 cup eq., p<0.01), and whole grains (0.57±0.08 oz. eq. vs. 0.39±0.09 oz. eq., p<0.05) compared with income-eligible nonparticipants. Compared with income-ineligible nonparticipants, Hispanic WIC participants consumed more fiber (13.0±0.6 g vs. 9.4±1.3 g, p<0.05), potassium (2195±62 mg vs. 1860±156 mg, p<0.05), and fewer added sugars (8.9±0.5 tsp. eq. vs. 14.6±1.5 tsp. eq., p<0.001). Among non-Hispanic black children, dietary intake was comparable by WIC participation status and income; however, differences were observed in the percentage that dairy and vegetable subgroups contributed to total dairy and total vegetable intake. Participation in the WIC program supports nutritional health status of minority children in the U.S.